Supplementary case reports to the current German Cardiac Society (DGK) position paper on electrical cardioversion

Electrical cardioversion represents a cornerstone of rhythm control strategies in patients with atrial fibrillation. However, in patients with obesity and specific anatomical variations, e.g. post heart transplantation, the standard flow of this procedure may need to be altered. This includes employing technical deviations of shock delivery and paying special attention to potential, unexpected complications. In light of the current position paper of the German Cardiac Society (Deutsche Gesellschaft für Kardiologie, DGK) on electrical cardioversion of atrial fibrillation, two cases with unconventional course of elective electrical cardioversion of atrial fibrillation are presented: dual direct current cardioversion in severe obesity and the occurrence of ventricular fibrillation in the presence of heterotopic heart transplant.